Korean Circ J.  2005 Dec;35(12):928-933. 10.4070/kcj.2005.35.12.928.

A Diagnostic Value of Ischemia Modified Albumin in Patients with Suspected Acute Coronary Syndrome with Normal EKG and Cardiac Markers

• Kim JY
• Yoon J
• Jung IH
• Wang HS
• Choi H
• Jung HS
• Kim H
• Yoo BS
• Lee SH
• Uh Y
• Hwang SO
• Choe KH

• KMID: 2227136
• DOI: http://doi.org/10.4070/kcj.2005.35.12.928

Abstract

BACKGROUND AND OBJECTIVES
In the early phase of acute chest pain, the diagnosis of acute coronary syndrome (ACS) is often difficult to achieve in an emergency department (ED) due to the non-diagnostic ECG and cardiac markers. Ischemia modified albumin (IMA) has recently been shown to be a sensitive early biochemical marker of ischemia. The aim of this study was to evaluate the diagnostic value of IMA for the patients with suspected ACS and who have normal ECG/cardiac markers.
SUBJECTS AND METHODS
We enrolled 142 consecutive patients who presented to the ED due to suspected ACS, and they had a normal EKG and troponin-I/CK-MB within 5 hours after the onset of their chest pain. The diagnosis of ACS was based upon the clinical findings, the results of serial ECG/troponin and the coronary angiography. The ideal cutoff value of IMA for ACS was calculated by the receiver operator characteristic (ROC) curve analysis.
RESULTS
The ACS was diagnosed in 80/142 (56%). The ROC curve area for the IMA test was 0.77 (CI; 0.70-0.85, p<0.01). At a cutoff value of 98.5 U/mL, the sensitivity, specificity and negative predictive values for ACS were 73%, 75% and 75%, respectively. At a cutoff value of 85 U/mL, the sensitivity and specificity and negative predictive values for ACS were 92%, 35% and 95%, respectively.
CONCLUSION
IMA might be a useful diagnostic marker of ACS for those patients with normal ECG/cardiac markers and who present within 5 hours after the onset of chest pain.

Keyword

Coronary disease; Ischemia; Myocardium

MeSH Terms

Acute Coronary Syndrome*
Biomarkers
Chest Pain
Coronary Angiography
Coronary Disease
Diagnosis
Electrocardiography*
Emergency Service, Hospital
Humans
Ischemia*
Myocardium
ROC Curve
Sensitivity and Specificity